Labcorp is seeking a
REMOTE Senior Manager, State Laws and Reimbursement Leader to join our team!
Work Schedule: Monday - Friday; 8:00am-5:00pm
ESTThe Senior Manager, State Laws & Reimbursement is responsible for monitoring, interpreting, and assessing state legislative and regulatory requirements that impact laboratory services, payer policy, billing, and reimbursement.
This role will serve as a subject matter expert on state laws and regulations affecting laboratory reimbursement and will evaluate the potential business and operational impact of these changes. The Senior Manager will partner across Payor Policy, Legal, Compliance, Government Affairs, Revenue Cycle, and other internal stakeholders to help ensure the organization understands and appropriately responds to evolving state requirements and leads a team to help facilitate communication of changes impacting policy, billing, and reimbursement to internal stakeholders.
The ideal candidate is an attorney with strong healthcare regulatory experience, understanding of the clinical laboratory industry, a working knowledge of payer policies, reimbursement, and managing a team.
Key Responsibilities- Monitor and analyze proposed and enacted state legislation, regulations, and regulatory guidance affecting clinical laboratories, reimbursement, billing, coverage, and payer requirements.
- Mentor and guide a team providing training on complex scenarios and best practices.
- Manage a team responsible for State Medicaid Policy and Reimbursement Issues.
- Facilitating peer to peer discussions with Medical Directors and subject matter experts.
- Evaluate the reimbursement and operational implications of state-specific requirements and communicate potential impacts to appropriate stakeholders.
- Research and interpret state laws and regulations related to laboratory services, including requirements that may affect coverage, reimbursement, claims processing, prior authorization, medical necessity, billing, and patient access.
- Provide subject matter expertise to Payor Policy and Revenue Cycle teams regarding the intersection of state regulatory requirements and payer reimbursement policies.
- Identify emerging state legislative and regulatory trends that may create reimbursement opportunities, risks, or operational impacts.
- Partner with Legal, Compliance, Government Affairs, Payor Policy, Revenue Cycle, and business leaders to develop appropriate responses to new or changing state requirements.
- Support efforts to identify discrepancies between payer policies or reimbursement practices and applicable state requirements.
- Translate complex legal and regulatory information into clear, actionable guidance for business and operational teams.
- Develop summaries, analyses, and executive-level communications regarding significant state legislative and regulatory developments.
- Maintain an organized framework for tracking state requirements and changes that affect laboratory reimbursement.
- Support strategic initiatives related to payer policy, reimbursement, and regulatory changes affecting laboratory services.
Minimum Qualifications:- 5+ years of relevant experience with Bachelor's degree or 7 years relevant experience with Associates degree.
Preferred Qualifications:- 2+ years experience within the clinical laboratory, diagnostic, pathology, genetic testing, or broader healthcare industry
- Juris Doctor (JD) degree from an accredited law school.
2+ years in Medicaid Reimbursement.
- 2+ years working knowledge of the laboratory revenue cycle.
- 2+ years experience interpreting healthcare laws, regulations, and regulatory guidance.
- 2+ years experience with Medicare, Medicaid and commercial payer policy, healthcare reimbursement, managed care, or revenue cycle.
- Strong understanding of the relationship between regulatory requirements, payer policies, reimbursement, and healthcare operations.
- Ability to research and interpret complex state statutes and regulations and translate findings into practical business recommendations.
- Excellent analytical, written, and verbal communication skills.
- Demonstrated ability to work effectively across Legal, Compliance, Government Affairs, operational, and business functions.
- Experience evaluating state laws and regulations affecting laboratory billing and reimbursement.
- Knowledge of payer coverage and reimbursement processes, including medical policy, prior authorization, claims adjudication, and reimbursement requirements.
- Familiarity with state legislative and regulatory processes and healthcare payer requirements.
- Experience working with government affairs, trade associations, or industry advocacy organizations on healthcare policy matters.
Additional Job Standards:- Regulatory and legal analysis
- Payer policy and reimbursement expertise
- Strategic thinking and problem solving
- Ability to translate complex requirements into business implications
- Executive-level communication
- Cross-functional collaboration
- Sound judgment and risk assessment
- Effectively manage a team of direct reports
- Ability to manage multiple state-specific issues and priorities simultaneously
Application Window Closes: 11-11-26Salary Range: $110,000-$130,000
All job offers will be based on a candidate's skills and prior relevant experience, applicable degrees/certifications, as well as internal equity and market data.
The position is also eligible for an annual bonus under the Labcorp Bonus Plan. Bonuses are payable based on corporate and/or business segment performance and are subject to individual performance modifiers.
Benefits: Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan. Employees regularly scheduled to work less than 20 hours, Casual, Intern, and Temporary employees are only eligible to participate in the 401(k) Plan. Employees who are regularly scheduled to work a 7 on/7 off schedule are eligible to receive all the foregoing benefits except PTO or FTO. For more detailed information, please click here.
